​​MaineCare Issuing Second Hospital Value-Based Purchasing (VBP) Supplemental Payments​​

MaineCare recently implemented its new VBP supplemental sub-pool payments, totaling $600,000, which the Department will distribute each year to eligible hospitals based on performance on one or more quality measures. This sub-pool helps align incentives across the health care system to drive desired outcomes. The 2022 and 2023 distribution of these funds will focus on primary care access among MaineCare members within designated Hospital Service Areas (HSAs).   

MaineCare implements new rate reforms supported by current services budget

Jun 6, 2023

While the Legislature considers budget proposals for future MaineCare reforms, the Department of Health and Human Services (DHHS) Office of MaineCare Services continues its implementation of payment rates already developed under the landmark law (P.L. 2022, Ch. 639 (PDF)). Specifically, the Office of MaineCare Services implemented reformed payment for Federally Qualified Health Centers effective March 1 and will implement an array of cost-of-living adjustments effective July 1.

CORRECTION: Attention Providers of Section 67 Nursing Facilities (NF) and Section 97, Residential Care Facilities (RCFs, PNMI Appendix C): Provider Rate Methodology Workgroup Presented Materials 

MaineCare, and its vendor will host the 5th Rate Workgroups meeting on June 26, 2023. Presented materials will then be posted to the Rate System Reform webpage shortly after. Please watch for future notices. 

Extended-Release Buprenorphine Clinical Use Criteria

In order to promote access to Sublocade, Extended Release Buprenorphine (XRB), MaineCare may engage in rulemaking. In the meantime, providers may bill the medical benefit for XRB without Prior Authorization (PA) if their documentation meets the criteria outlined below. The criteria will be available on the Preferred Drug List after the July 2023 update. Failure to meet these criteria could result in sanctions.    

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